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A man is brought to the emergency department following a bar fight and is treated for a deep laceration on his left cheek. On physical examination, there is no jaw deviation. He is able to blink, close his eyes tightly, wrinkle his forehead, and move his tongue symmetrically. Sensation throughout the face is intact. However, on closer inspection, the left corner of his mouth droops.

Using the image as a guide, through which of the following cranial structures does the damaged nerve pass?

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]]>http://www.firstaidteam.com/8582/usmle-rx-step-1-qmax-challenge-3952/feed8Announcing the One App to Rule them All! Get Qmax on iTunes!http://www.firstaidteam.com/8576/announcing-the-one-app-to-rule-them-all
http://www.firstaidteam.com/8576/announcing-the-one-app-to-rule-them-all#commentsSat, 25 Jul 2015 11:59:01 +0000http://www.firstaidteam.com/?p=8576You can now access all of your Qmax subscriptions from one FREE iOS app.

The USMLE-Rx app, now available on iTunes, gives you on-the-go access to your Step 1 Qmax, Step 2 Qmax, and Step 3 Qmax subscriptions, all in one app.

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A full-term baby is born to a 26-year-old woman who did not seek medical care during her pregnancy. The baby does well initially, but develops red eyes with purulent discharge on day 13. The responsible organism from a special cell culture is is shown in the image.

The infectious agent most likely responsible for this baby’s condition is also involved in the pathogenesis of which neonatal disease?

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I was at a conference for premedical students a few months ago, and Patch Adams was there giving both the keynote speech along with several workshops. After the conference, 40 or so attendees gathered around him on the lawn, peppering him with questions. Finally, one particularly astute premedical student asked him the question:

“If you could tell only one thing to pre-medical and medical school students, what would it be?”

Without pausing, he said, “You can be the kind of doctor you want to be, no matter what that is.”

When Dr. Adams was in his late teens, he was committed to a mental institution three times for suicidal thoughts. During his third stay, he had the epiphany that would shape his life forever. He wanted to become a doctor and use medicine as an avenue for social change. He did not know at the time what that would look like, exactly, but he was clear about two things: 1.) He was going to be a free doctor and 2.) He was going to be about love above everything else. He went on to describe what each of these commitments looked like in his professional life.

Money
When he graduated from Virginia Commonwealth University Medical School in 1971, Dr. Adams moved into a large house with 20+ friends and they started calling themselves a hospital. From that day, until they closed in 1983 (to broaden their cause through outreach), they had 5-50 overnight guests every night and saw a total of approximately 15,000 patients. They never charged a dime to a single patient. In fact, they ripped up checks that were secretly left for them. To this day, at the age of 70, Patch has yet to accept money for providing healthcare.

Love
Patch hugs people – especially his patients. For his initial patient interview, Patch goes to his patients’ houses. Over the course of several hours, he asks them everything about their lives because he wants them to feel listened to, understood, loved. He wears ridiculous clothing, not because he wants attention, but because he wants his “weird” appearance to help people feel more comfortable with their own uniqueness. He believes that loving and accepting those around you starts with loving and accepting yourself. When he first decided to go on clown trips, he picked a country that personified “the enemy” at the time: Russia. It’s easy to bring joy to a welcoming audience. It’s a true and defiant act of love when it’s offered to an enemy.

Patch made it clear that his choices weren’t easy. He proudly spoke of working as a file clerk in order to make ends meet financially without compromising on his commitment to never accept money for his professional services. What he didn’t mention, but it was clear to see, was that in taking this stance, he had also declared himself an enemy to any organization that profited off of people’s sickness. This attitude, while in line with his deepest beliefs, has hindered his progress towards achieving other goals (e.g. raising funding from “for profit” healthcare organizations).

But, while these extreme ideals were difficult and costly to live by at times, they were not impossible and the journey was completely worth it. So if your heart leads you towards something that’s not only ambitious but also unorthodox, know that you can make progress that will be immensely rewarding, even if what you set out to achieve is not accomplished completely. That’s certainly true of Patch Adams. While part of Patch’s dreams have come true (an orphanage in Russia) part have not (the Gesundheit Institute Hospital a free hospital built around Patch’s model for health care). But such is the nature of chasing something that’s difficult and that has never been done before.

Unlike his professional goals, Patch’s soul is 100% intact, even after a lifetime in medicine. And in his experience, being the kind of doctor you want to be, congruent with your truest self, while accomplishing only a fraction of your professional goals, is infinitely more rewarding than “succeeding” in an area that’s not in line with your heart’s calling.

So, remember what kind of doctor you came to medical school to become. Never stop chasing that. Because you’ve got nothing to lose that matters. And everything to gain that does.

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A previously healthy 41-year-old man misses several days of work as a result of a viral illness with symptoms including fever, headache, and fatigue. He also experiences a nonproductive cough and a sore throat. By the third day, his symptoms begin to subside and he is able to return to work. The next week, however, he experiences a rapid relapse. His cough returns, but now it is a productive cough with mucopurulent sputum. He also begins to experience pleuritic chest pain. On visiting a physician, x-ray of the chest is ordered and is shown in the image.

Which of the following describes the structure of the viral genome that most likely caused his initial illness?

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A 1-month-old girl presents to the emergency department with emesis. She was feeding well on breast milk until 1 week ago, when she began to have nonbilious emesis immediately after feeding. The episodes have progressed, and are now occurring after every meal with nonbilious projectile emesis. Her parents are surprised that the patient attempts to feed soon after every episode of emesis. They think she has become less active and has lost weight. Her temperature is 36.8°C (98.2°F), respiratory rate is 30/min, heart rate is 160/min, and blood pressure is 88/55 mm Hg. Her abdomen is nondistended and mildly tender diffusely. There is a palpable, mobile, olive-shaped mass in the mid-epigastric region. Ultrasound imaging of the abdomen is shown in the image.

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscriptionand get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

]]>http://www.firstaidteam.com/8548/usmle-rx-step-1-qmax-challenge-3902/feed7Remember to Re-Subscribe!http://www.firstaidteam.com/8491/sign-up-to-stay-in-touch
http://www.firstaidteam.com/8491/sign-up-to-stay-in-touch#commentsMon, 06 Jul 2015 04:36:41 +0000http://www.firstaidteam.com/?p=8491As we transition the First Aid Team blog to bigger and better things, we need to inform you that our current system of daily digests as distributed by Feedburner will be discontinued by the end of this month. Our new daily digests will contain more information and present First Aid Team.com posts in a more pleasing way.

If you have not done so already, please re-subscribe to the First Aid Team blog before June 30, 2015. The new daily digest emails will begin on July 1, 2015!

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We look forward to more exciting and informative communications with you!

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A 27-year-old woman presents to her primary care physician complaining of feeling “under the weather” for the past 2 weeks. Her history is remarkable only for previously diagnosed mitral valve prolapse. On examination, her temperature is 37.8°C (100°F). The patient has erythematous palms and painful, small lesions on her finger pads. The results of an ophthalmologic examination are shown in the image.

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]]>http://www.firstaidteam.com/8542/usmle-rx-step-1-qmax-challenge-3390-2/feed7Last Day to Get $100.00 Off a Till You Pass Triple Play Subscription!http://www.firstaidteam.com/8521/get-100-00-off-a-till-you-pass-triple-play-subscription
http://www.firstaidteam.com/8521/get-100-00-off-a-till-you-pass-triple-play-subscription#commentsTue, 30 Jun 2015 04:04:08 +0000http://www.firstaidteam.com/?p=8521Hurry! Today is the last day to save $100.00 on a Till You Pass subscription to Step 1 Triple Play!

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